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Boils, carbuncles, folliculitis, paronychia and staphylococcal whitlow - Management
Are there any other key issues I should be aware of before prescribing?

Flucloxacillin

  • Flucloxacillin has been associated with an increased risk of hepatic disorders, namely hepatitis and cholestatic jaundice.
  • The Committee on Safety of Medicines (CSM) advises that hepatic reactions may occur up to 2 months after treatment with flucloxacillin has stopped. Risk factors include treatment for more than 14 days and increasing age. The dose and route of administration do not appear to affect this risk.

Erythromycin and clarithromycin

  • Erythromycin commonly causes gastrointestinal adverse effects, especially at higher doses. If this is known to occur, consider prescribing clarithromycin instead.
  • Erythromycin and clarithromycin can increase the levels of certain other drugs (e.g. theophylline, carbamazepine) and can potentiate the effects of warfarin.
  • They can also prolong the QT interval. If possible, avoid giving erythromycin or clarithromycin if the person is already taking a drug that can potentially prolong the QT interval (e.g. antiarrhythmics, antipsychotics, tricyclic antidepressants) or if the person has hypokalaemia, which also increases the risk of QT prolongation.
  • If they are taken with a statin, there is an increased risk of myopathy.

Ibuprofen

  • As with other nonsteroidal anti-inflammatory drugs, ibuprofen may worsen or precipitate gastrointestinal haemorrhage, asthma, hypertension, renal impairment, or cardiac failure. Avoid ibuprofen if there is a history of peptic ulcers, and in pregnant women.

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